One example of this invaluable support is something that we have experienced with many organisations. In fact, this could be almost any healthcare organisation. The scenario goes like this:

The organisation has a ‘Water Safety Plan', comprising a safe water policy & procedures, up to date Legionella risk assessments, schematic drawings and a scheme of control measures that has been implemented across all of their sites. The scheme appears to be effective at all sites except one. One site that repeatedly tests positive for Legionella bacteria despite the usual remedial actions and best intentions.

As the Authorising Engineer [Water] we would want to support our client in finding the root cause and taking appropriate action. This would typically involve a site visit and an inspection of the water system. Often these are things that bacterial and engineering risk assessments should have picked up but, for whatever reason, have not. This is, for all intent and purposes, a review of the risk assessment as a result of findings evidence that the control scheme is not effective. We’re often told that the Authorising Engineer [Water] should not undertake risk assessments but it is the AE[W] who has the necessary skills and experience to unravel the evidence when the standard precautions are ineffective.

Problems with Legionella bacteria colonising water systems have a root cause, if you don’t know what it is, it probably means you haven’t found it yet. Investigations prompted by the Authorising Engineer [Water] will often uncover faults such as poor temperature control, inadequate circulation in hot water return pipework, poor flow rates, TMV faults, previously unidentified dead-legs, infrequent use, hidden components such as flexible hoses, partially closed valves etc. Sometimes speaking to local staff raises questions about system performance, usage patterns or potential sources of contamination. Human error often plays a part, actual investigations have discovered:

One of a pair of calorifiers was found to be operating below the target temperature of 60°C due to a failed heating system. The other calorifier was compensating for the failure and incompetent monitoring did not detect the temperature deficit leading to unpasteurised water entering the distribution system.

Extensive and clearly visible dead-end pipework was found in an office meeting room that had been overlooked by the risk assessor. The block was formerly a ward and the meeting room was once the bathroom – highlighting the need for risk assessors to consider the history of the building and adapt their survey accordingly.

Flexible hoses were discovered behind IPS panels in a refurbished ward area. On review the hoses had been identified in the previous risk assessment but, contrary to the recommended actions, had not been removed. Managers should ensure that there are processes in place to check that works have been completed satisfactorily and not rely only on computer read-outs.

In another case, water samples destined for Legionella analysis were taking up to 7-days to be delivered to the laboratory despite guidelines stating that samples preferably should be delivered to the laboratory within 24-hours and that analysis should commence within a maximum of 72-hours. The outcome of any delay was unreliable results and wasted resources.

In these troublesome and often complex instances the experience of the Authorising Engineer [Water] combined with the Authorised Person’s knowledge of the site is a powerful force, but even then, it is often the plumber or the cleaner, the eyes and ears on the ground, who hold the key to uncovering the fault.

There is sometimes a bit of tension or mistrust between trades-staff and their managers, as an Authorising Engineer [Water] it can help not to take sides and, in a manner of speaking, befriend everyone..... but perhaps trust no-one entirely! If there’s one thing this shows, it’s that as an AE[W] we often come against poor communication within the organisations we serve.

Authorising Engineer [Water] as a Foe

For all the ways that we aim to help our colleagues, sometimes it may be necessary to lock horns. This can happen in a variety of ways but here are some examples:

Sometimes it is necessary for an Authorising Engineer [Water] to tell clients home truths about the performance of the service:

In extreme circumstances an Authorising Engineer [Water] may be called upon to be a whistle blower when organisations are failing. Furthermore, there have been cases when an AE [W] is called upon to give evidence for the prosecution in the event of legal proceedings.

Everyone has heard the story of the Emperor’s new clothes… An AE’s intention is to act as a friend and although “friends don’t like to tell” it is sometimes only a true friend who will tell the truth. When these circumstances occur it can be a “bitter pill” and sometimes results in negative behavioural traits emerging.

In another scenario, an Authorising Engineer [Water] could be considered an enemy if they are not acting impartially, for example when the AE[W] has a vested interest in up-selling services that are not included in their role.

As Authorising Engineer's we have a duty that comes with the role to provide an informed view of compliance within the healthcare organisation. Professionally, that view must be impartial and accurate to the extent that it won’t always go down well with our friends.

The work of an Authorising Engineer [Water] can help clients avoid long-term problems but it sometimes creates difficulties for individuals & teams in the short term. To help minimise these events AEs should:

Engage with as many stakeholders as possible through the Water Safety Group and other opportunities;

Encourage self-sufficiency in their clients – don’t make yourself indispensable for the wrong reasons

The Authorising Engineer, regardless of discipline, is there to support as a ‘friend’ but may be considered a ‘foe’ by some if they don’t like the message.

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The Water Hygiene Centre was established in 2009 to address the lack of independent consultancy within the industry. Since then we have established ourselves as a market leader and have steadily grown, helping clients identify and minimise the risk of waterborne contamination and disease, whilst improving compliance performance.